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The Chief Complaint: Dr. Otis Brawley (re: issues with medical system)
http://www.atlantamagazine.com/features/story.aspx?ID=1648804
In an excerpt from his forthcoming book, an Emory professor and former Grady cancer director pulls back the curtain on the medical machine 2/1/2012
For a man with such respectable bona fides—University of Chicago medical school graduate, trained in oncology at the National Cancer Institute, Emory professor, and currently chief medical officer at the American Cancer Society—Dr. Otis Brawley sure knows how to piss people off. Since long before October, when he spoke out to the New York Times Magazine, he’s been accused of prosecuting an irrational “vendetta” against use of the prostate-specific antigen (PSA) test to screen apparently healthy men for prostate cancer. Some critics say he’s killing men by steering them away from this test, which in the best cases leads to lifesaving treatment but in worse cases leaves men impotent and incontinent after treatment for growths that posed no danger.
Brawley is no stranger to controversy. He jokes that he’s the “Forrest Gump of medicine” because he has been in the thick of historic medical advances and debates for thirty years. Mere fortune made Gump a war hero and a shrimp tycoon. But it wasn’t luck that joined Brawley with the team that pioneered the first effective AIDS drugs, or with Surgeon General David Satcher in the battle against health disparities, or with President Clinton in apologizing for the infamous Tuskegee experiment.
In 2002 Brawley became chief of oncology and hematology at Grady Hospital. Though no longer in a leadership position at Grady, Brawley still practices there. His experiences at Grady partly inspired his new book, "How We Do Harm: A Doctor Breaks Ranks About Being Sick in America" (with Paul Goldberg, St. Martin’s Press). In what he calls “a guided tour through the back rooms of American medicine,” Brawley not only takes on the unfolding catastrophe of U.S. healthcare, but also hits closer to home with chilling stories about irresponsible doctors here in Atlanta, such as some who dispense inappropriate, even life-threatening chemo. To accompany the following excerpt, veteran health and medical journalist Patricia Thomas talked with Brawley about his new book.
In your book, you say that instead of having a healthcare “system,” we Americans live in a fragmented universe where famine and gluttony exist side by side. What do you mean? Cervical cancer is a good example of famine and gluttony. Ten years ago, most organizations that issue screening guidelines started saying that women who had two or three normal Pap smears in a row, and who were in a stable relationship, could go to every three years for Pap smears. And many doctors and many middle-class and upper-class women were outraged. They wanted their annual test. Every year about 4,290 women die from cervical cancer. The majority of them have never had a Pap smear, ever. And of those who have, the overwhelming majority had not had one within ten years of their diagnosis. The women who died never got the services they needed. Then you’ve got all the folks who are upset because we say they should be tested every three years instead of every year.
In an excerpt from his forthcoming book, an Emory professor and former Grady cancer director pulls back the curtain on the medical machine 2/1/2012
For a man with such respectable bona fides—University of Chicago medical school graduate, trained in oncology at the National Cancer Institute, Emory professor, and currently chief medical officer at the American Cancer Society—Dr. Otis Brawley sure knows how to piss people off. Since long before October, when he spoke out to the New York Times Magazine, he’s been accused of prosecuting an irrational “vendetta” against use of the prostate-specific antigen (PSA) test to screen apparently healthy men for prostate cancer. Some critics say he’s killing men by steering them away from this test, which in the best cases leads to lifesaving treatment but in worse cases leaves men impotent and incontinent after treatment for growths that posed no danger.
Brawley is no stranger to controversy. He jokes that he’s the “Forrest Gump of medicine” because he has been in the thick of historic medical advances and debates for thirty years. Mere fortune made Gump a war hero and a shrimp tycoon. But it wasn’t luck that joined Brawley with the team that pioneered the first effective AIDS drugs, or with Surgeon General David Satcher in the battle against health disparities, or with President Clinton in apologizing for the infamous Tuskegee experiment.
In 2002 Brawley became chief of oncology and hematology at Grady Hospital. Though no longer in a leadership position at Grady, Brawley still practices there. His experiences at Grady partly inspired his new book, "How We Do Harm: A Doctor Breaks Ranks About Being Sick in America" (with Paul Goldberg, St. Martin’s Press). In what he calls “a guided tour through the back rooms of American medicine,” Brawley not only takes on the unfolding catastrophe of U.S. healthcare, but also hits closer to home with chilling stories about irresponsible doctors here in Atlanta, such as some who dispense inappropriate, even life-threatening chemo. To accompany the following excerpt, veteran health and medical journalist Patricia Thomas talked with Brawley about his new book.
In your book, you say that instead of having a healthcare “system,” we Americans live in a fragmented universe where famine and gluttony exist side by side. What do you mean? Cervical cancer is a good example of famine and gluttony. Ten years ago, most organizations that issue screening guidelines started saying that women who had two or three normal Pap smears in a row, and who were in a stable relationship, could go to every three years for Pap smears. And many doctors and many middle-class and upper-class women were outraged. They wanted their annual test. Every year about 4,290 women die from cervical cancer. The majority of them have never had a Pap smear, ever. And of those who have, the overwhelming majority had not had one within ten years of their diagnosis. The women who died never got the services they needed. Then you’ve got all the folks who are upset because we say they should be tested every three years instead of every year.
